[19F] Experiencing severe lower back pain and gastrointestinal symptoms

Patient Description

A 19-year-old female presents with a constellation of symptoms including a severe dull ache in the mid to lower back, earache with sharp pain upon standing, headache, stomach tightness, nausea without vomiting, and gassiness. The lower back pain is exacerbated by movement and stretching, and nothing has relieved it so far. The patient has also noted spotting between menstrual cycles, with the last period starting on February 4th and a typical cycle length of 29 days. There has been no recent back injury, no changes in urination, and no significant weight changes during the menstrual cycle. The patient reports feeling cold but is unsure if it is related to an illness or the ambient temperature in the house.

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Arora's Assessment

What might be happening

Based on the information you've provided, here are a few possibilities:

  • Urinary Tract Infection (UTI): UTIs can cause lower back pain, nausea, and a general feeling of being unwell. However, you mentioned that you haven't noticed any changes when you urinate, which is a common symptom of UTIs.

    • Treatment typically involves antibiotics prescribed by a doctor.
  • Kidney Stones: These can cause severe lower back pain, nausea, and sometimes spotting. However, you didn't mention any pain while urinating, which is a common symptom of kidney stones.

    • Treatment can range from pain management at home to medical procedures, depending on the size of the stone.
  • Gastroenteritis: This is an inflammation of the stomach and intestines, usually due to a viral or bacterial infection. It can cause stomach pain, nausea, and general discomfort.

    • Treatment usually involves rest, hydration, and over-the-counter medication to manage symptoms.
  • Pregnancy: Some of your symptoms, such as lower back pain, nausea, and spotting, can be early signs of pregnancy. However, it's important to take a pregnancy test to confirm this.

    • If you are pregnant, it's important to start prenatal care as soon as possible.
  • Ear Infection: This could explain your earache. It's usually caused by a bacterial or viral infection.

    • Treatment typically involves antibiotics or antiviral medication prescribed by a doctor.

What you can do

It's important to consult a healthcare professional who can provide a formal assessment and order relevant tests if necessary. In the meantime, here are some things you can do:

  1. Stay hydrated and rest as much as possible.
  2. Over-the-counter pain relievers can help manage your back pain and earache.
  3. If you're sexually active and there's a chance you could be pregnant, consider taking a home pregnancy test.
  4. Monitor your symptoms and note any changes or new symptoms.

What you should look out for

Here are some signs that you should seek medical attention immediately:

  • Severe pain that doesn't improve with rest or over-the-counter medication.
  • High fever (temperature over 100.4°F) or chills.
  • Blood in your urine.
  • Severe or worsening nausea and vomiting.
  • Any other symptoms that concern you or interfere with your daily activities.

Remember, I'm an AI and not a doctor. It's important to consult with a healthcare professional for a formal diagnosis and treatment.

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11 mo ago

People Also Ask


What are the common symptoms of a urinary tract infection (UTI)?

Common symptoms of a UTI include a strong, persistent urge to urinate, a burning sensation when urinating, passing frequent, small amounts of urine, cloudy or strong-smelling urine, and pelvic pain in women.


How can I differentiate between kidney stones and a UTI based on symptoms?

Kidney stones often cause severe pain in the back or side, nausea, vomiting, and sometimes blood in the urine. UTIs typically cause a burning sensation during urination, frequent urination, and cloudy urine. Pain during urination is more common with UTIs.


What are the early signs of pregnancy that I should be aware of?

Early signs of pregnancy can include missed periods, nausea or morning sickness, tender or swollen breasts, increased urination, fatigue, and spotting or light bleeding known as implantation bleeding.


What are the typical symptoms of an ear infection?

Typical symptoms of an ear infection include ear pain, difficulty hearing, fluid drainage from the ear, fever, and irritability. In some cases, there may be a feeling of fullness in the ear or balance issues.


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